Is misoprostol a safe, effective and acceptable alternative to manual vacuum aspiration for postabortion care? Results from a randomised trial in Burkina Faso, West Africa
Abstract
Objectives Previous research has demonstrated the effectiveness of misoprostol for treatment of incomplete abortion; however, few studies have systematically compared misoprostol's effectiveness with that of standard surgical care. This study documents the effectiveness of a single 600 micrograms dose of oral misoprostol versus manual vacuum aspiration (MVA) for treatment of incomplete abortion in a developing country setting. Design Open-label randomised controlled trial. Setting Two university teaching hospitals in Burkina Faso, West Africa. Population Women of reproductive age presenting with incomplete abortion. Methods From April 2004 through October 2004, 447 consenting women with incomplete abortion were randomised to either a single dose of 600 micrograms oral misoprostol or MVA for treatment of their condition. Main outcome measure Completed abortion following initial treatment. Results Regardless of treatment assigned, nearly all participants had a complete uterine evacuation (misoprostol = 94.5%, MVA = 99.1%; relative risk [RR] = 0.95 [95% CI 0.92-0.99]). Acceptability and satisfaction ratings were similar and high for both misoprostol and MVA, with three out of four women indicating that the treatment's adverse effects were tolerable (misoprostol = 72.9%, MVA = 75.8%; RR = 0.96 [95% CI 0.86-1.07]). The majority of women were 'satisfied' or 'very satisfied' with the method they received (misoprostol = 96.8%, MVA = 97.7%; RR = 0.99 [95% CI 0.96-1.02]), expressed a d…
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Trials in Burkina Faso, Mozambique, Tanzania, and Uganda have shown promising results of misoprostol being a satisfactory substitute for the treatment of incomplete abortion.
“Trials of the technique in Burkina Faso (41), Mozambique (42), Tanzania (43) and Uganda (44) have shown promising results of misoprostol being a satisfactory substitute for the treatment of incomplete abortion, and misoprostol is increasingly being considered as a method to address women's poor access to postabortion care.”
From Unsafe abortion and postabortion care - an overview (2011) · cites this paper as [41]
Cites
Trinder, J., Brocklehurst, P., Porter, R., Read, M., Vyas, S., & Smith, L. (2006) · BMJ · doi:10.1136/bmj.38828.593125.55 · Cited by 299 · see citing works
Early intrauterine pregnancy failure: A randomized trial of medical versus surgical treatment
Muffley, P. E., Stitely, M. L., & Gherman, R. B. (2002) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2002.126205 · Cited by 70 · see citing works
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Abortion Worldwide 2017: Uneven Progress and Unequal Access
Singh, S., Remez, L., Sedgh, G., Kwok, L., & Onda, T. (2018) · doi:10.1363/2018.29199 · Cited by 432 · see citing works
Unsafe abortion and postabortion care - an overview
RASCH, V. (2011) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2011.01165.x · Cited by 94 · see citing works
- Authors
- Dao, B., Blum, J., Thieba, B., Raghavan, S., Ouedraego, M., Lankoande, J., & Winikoff, B.
- Affiliations
- Gynuity Health Projects (US)
- Corresponding author
- Blum, J
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2007-09-05
- Volume
- 114
- Issue
- 11
- Pages
- 1368-1375
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2036678127
- Cited by
- 88
- References
- 2
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2023: 6 · 2021: 3 · 2020: 2 · 2019: 5 · 2018: 4 · 2017: 1 · 2016: 3 · 2015: 5 · 2014: 15 · 2013: 8 · 2012: 9
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- David and Lucile Packard Foundation
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Social Sciences › Political Science and International Relations › International Human Rights and Reproductive Law
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Keywords
- misoprostol, manual vacuum aspiration, incomplete abortion, post-abortion care, uterine evacuation, treatment acceptability, patient satisfaction, treatment safety, Burkina Faso, developing countries, women's health services, obstetric care, abortion access
- MeSH terms
- Abortifacient Agents, Abortifacient Agents, Nonsteroidal, Abortion, Incomplete, Abortion, Induced, Burkina Faso, Female, Humans, Postnatal Care, Pregnancy, Vacuum Curettage, Misoprostol, Patient Satisfaction
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